Donor-intrinsic variables determine mobilization efficiency: analyses from a cohort of sixty twice-mobilized stem cell donors.

Autor: Kim-Wanner SZ; German Red Cross Blood Service Baden-Wuerttemberg-Hessen, Institute Frankfurt, Frankfurt, Germany.; Department of Regional Evaluation and Accounting, Hessian Cancer Registry, Office of State Examination and Examination in the Health Service, Frankfurt, Germany., Lee SY; German Red Cross Blood Service Baden-Wuerttemberg-Hessen, Institute Frankfurt, Frankfurt, Germany., Seifried E; German Red Cross Blood Service Baden-Wuerttemberg-Hessen, Institute Frankfurt, Frankfurt, Germany.; Institute for Transfusion Medicine, Goethe University Medical School, Haus 76, Sandhofstr. 1, 60528, Frankfurt, Germany., Bonig H; German Red Cross Blood Service Baden-Wuerttemberg-Hessen, Institute Frankfurt, Frankfurt, Germany. h.boenig@blutspende.de.; Institute for Transfusion Medicine, Goethe University Medical School, Haus 76, Sandhofstr. 1, 60528, Frankfurt, Germany. h.boenig@blutspende.de.; Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. h.boenig@blutspende.de.
Jazyk: angličtina
Zdroj: Journal of translational medicine [J Transl Med] 2020 Dec 18; Vol. 18 (1), pp. 487. Date of Electronic Publication: 2020 Dec 18.
DOI: 10.1186/s12967-020-02634-z
Abstrakt: Background: Healthy volunteer registry donors have become the backbone of stem cell transplantation programs. While most registrants will never become actual donors, a small minority are called upon twice, most commonly for the same patient because of poor graft function. Anecdotal evidence provides no hard reasons to disallow second-time mobilized apheresis, but few centers have treated enough two-time donors for definitive conclusions. Moreover, for reasons unknown, the efficiency of G-CSF varies greatly between donations.
Methods: Comparison of outcomes of first vs. second donations can formally confirm G-CSF responsiveness as intrinsically, likely genetically, determined. In our database, we identified 60 donors (1.3%) who received two cycles of G-CSF 24 days to 4 years apart and systematically compared mobilization outcomes.
Results: First and second mobilization and collection proceeded without severe or unusual adverse effects. First-time mobilization efficiency was highly predictive of second-time mobilization. Neither mobilization efficiency nor time lag between donations affected the similarity of first- and second-time mobilization outcomes.
Conclusions: With the caveat that only donors with an unremarkable first donation were cleared for a second, our data indicate that a second donation is feasible, equally tolerable as a first donation, and efficient. Moreover, the data strongly support the notion of donor-intrinsic variables dictating mobilization response and argue against relevant damage to the stem cell compartment during mobilization with rhG-CSF.
Databáze: MEDLINE
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